大鼠脑出血致多器官功能障碍综合征模型下丘脑、延髓内脏带与迷走神经的作用  

The functions of hypothalamus, medullary visceral zone and vagus nerve in multiple organ dysfunction syndrome model induced by cerebral hemorrhage of rats

作　　者：贺雅婷[1] 郭洪志[1] 屈传强[1] 王蕾[2] 贺燕[2] 麻琳[1] 齐新[3] 娄建伟[1] 王兴邦 

机构地区：[1]山东大学齐鲁医院神经内科,济南250012 [2]山东中医药大学第二附属医院神经内科 [3]中国医学科学院北京协和医院神经内科 [4]山东交通医院血栓科

出　　处：《中华神经科杂志》2011年第3期190-195,共6页Chinese Journal of Neurology

摘　　要：目的 ①探讨脑出血（CH）致多器官功能障碍综合征（MODS）大鼠模型下丘脑、延髓内脏带（MVZ）及迷走神经的作用;②揭示脑源性多器官功能障碍综合征（CMODS）时下丘脑、延髓内脏带及迷走神经的可能调控机制.方法 Wistar大鼠80只用随机数字表法分为：假手术组（10只）、迷走神经切断（SDV）组（10只）、CH组（20只）、脑出血＋迷走神经切断（CH＋SDV）组（20只）、脑出血＋迷走神经刺激（CH＋SIV）组（20只）.尾状核胶原酶注入法制作大鼠CH模型,偶氮显色鲎试验法定量测定血清内毒素,免疫组织化学法检测下丘脑FOS蛋白及延髓内脏带（MVZ）内乙酰胆碱转移酶（CHAT）的表达.结果 CH＋SDV组、CH＋SIV组和CH组的肝、肾功能,心肌酶异常程度均重于假手术组和SDV组,CH＋SDV组重于CH组,而CH＋SIV组明显轻于CH组;CH组血清内毒素含量（EU/m1）与假手术组比较差异有统计学意义（1.03±O.25与0.18±0.03,t=10.61,P〈0.01）;CH＋SDV组下丘脑内FOS蛋白的表达（9.3±2.6）明显多于假手术组（2.5±0.4,t=8.17,P〈0.01）和SDV组（2.9±0.5,t=7.64,P〈0.01）,但明显少于CH组（48.6±18.1,t=6.80,P〈0.01）,CH＋SIV组明显多于CH组（74.3±6.3与48.6±18.1,t=4.23,P〈0.01）;CH＋SDV组的MVZ内CHAT的表达（138.5±11.8）明显多于假手术组（108.2±9.5,t=5.39,P〈0.01）和SDV组（110.7±9.9,t=4.83,P〈0.01）,但明显少于CH组（164.4±12.4,t=3.53,P〈0.01）,CH＋SIV组明显多于CH组（189.4±15.0与164.4±12.4,t=3.14,P〈0.05）.结论 ①下丘脑与CH致MODS的神经免疫调节有关;②下丘脑-延髓内脏带-迷走神经通路机制可能是CMODS的特性;③迷走神经可能是CH致MODS的双向调节通路.Objective To investigate the role of the hypothalamus, medullary visceral zone （MVZ）and vagus in cerebral hemorrhage （CH） in multiple organ dysfunction syndrome （MODS） rat model.To reveal the possible regulatory mechanism of the hypothalamus-MVZ-vagus pathway in CMODS.Methods 80 Wistar rats were randomly divided into sham-operative group （n = 10）, subdiaphragmatic vagotomy group （SDV, n = 10）, CH group （n = 20）, CH ＋ SDV group （n = 20） and CH ＋ vagus stimulation group （CH ＋SIV, n = 20）.Rat CH model was made by stereotaxis injection of collagenase in caudate nucleus.Its endotoxin in serum was evaluated with a test kit.The expression of FOS in the hypothalamus and CHAT in the MVZ in the rats were examined using immunohistochemistry methods.Results Abnormality of hepatic and renal function, myocardium enzyme in CH ＋ SDV group, CH ＋ SIV group and CH group were more severe than those in sham-operative group and SDV group; CH ＋ SDV group more severe than CH group.CH ＋SIV group were much milder than CH group.The serum endotoxin level （EU/ml） in CH group,compared with the sham-operated group, were significantly different （1.03 ± 0.25 and 0.18 ± 0.03respectively, t = 10.61, P 〈0.01）.The expression of FOS in hypothalamus of CH ＋ SDV group （9.3 ±2.6） were significantly higher than those in sham-operative group （2.5 ± 0.4, t = 8.17, P 〈 0.01） and SDV group （2.9 ±0.5, t =7.64, P 〈0.01）, but significantly lower than those in CH group （48.6 ± 18.1,t =6.80, P〈0.01）; was higher in CH ＋SIV group than those in CH group （74.3 ±6.3 and 48.6 ± 18.1,t=4.23, P 〈0.01）.The expression of CHAT in MVZ in CH ＋ SDV group （138.5 ± 11.8） was significantly higher than those in sham-operative group （108.2 ±9.5, t =5.39, P 〈0.01） and SDV group （110.7 ±9.9, t =4.83, P 〈0.01）, but significantly lower than those in CH group （164.4 ± 12.4, t =3.53, P 〈0.01）; was higher in CH ＋ SIV group than in CH group （189.4 ± 15.0 and 164.

关 键 词：脑出血 多器官功能衰竭 疾病模型 动物 内毒素类 迷走神经 

分 类 号：R459.7[医药卫生—急诊医学]